BRILLIANT MINDS (NPI# 1720101736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720101736 |
| Entity Type | Organization |
| Organization Name | BRILLIANT MINDS |
| Practice Address |
36468 Emerald Coast Pkwy Suite 2101 Destin FL 32541-4799 |
| Mailing Address |
36468 Emerald Coast Pkwy Suite 2101 Destin FL 32541 |
| Practice Telephone | 8508371200 |
| Practice Fax Number | 8502692341 |
| Mailing Telephone | 8508371200 |
| Mailing Fax Number | 8502692341 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MISS GINA M BALLONE (CLINCAL DIRECTOR) |
| Authorized Official Telephone | 8508371200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 90051001284 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356963284 | Brilliant Minds | Home Health | 405 Danbury Ct, Spartanburg, SC 29301-5381 | 2020-05-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BRILLIANT MINDS ACADEMY INC | 405 Danbury Ct, Spartanburg, SC 29301-5381 |
| Virginia Business Entities | Brilliant Minds Childcare LLC | 24 Cavalier Blvd, Portsmouth, Virginia 23701 |
| New York State Corporations | BRILLIANT MINDS COLLECTIVE INC. | 165 Crescent Ct, Englewood, Nj 07631 |
| Colorado Business Entities | Brilliant Minds Corp. | 5890 S. Jebel Way, Centennial, CO 80015 |
| New York State Corporations | BRILLIANT MINDS GROUP FAMILY DAYCARE LLC | 1349 Gipson Street, Far Rockaway, Ny 11691 |
| Connecticut Business Registrations | Brilliant Minds LLC | 1103 North Street, White Plains, NY 10605 |
| System for Award Management (SAM) Entities | BRILLIANT MINDS MEDIA INC. | 481 Pueo Dr, Kula, HI 96790-7249 |
| New York State Corporations | BRILLIANT MINDS NY LLC | 1103 North Street, White Plains, New York 10605 |
| Oregon Corporations, Companies and Business Names | BRILLIANT MINDS PRESCHOOL AND CHILD CARE LLC | 10180 Nw Brady Ln, Portland, OR 97229 |
| System for Award Management (SAM) Entities | BRILLIANT MINDS SOLUTIONS | 733 Hindry Ave C205, Inglewood, CA 90301-3059 |
| Street Address |
36468 EMERALD COAST PKWY SUITE 2101 |
| City | DESTIN |
| State | FL |
| Zip Code | 32541-4799 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164753398 | Megan Clementine Bausch | Behavioral Analyst | 36468 Emerald Coast Pkwy, Suite 2101, Destin, FL 32541-4799 | 2010-01-28 |
| 1992033294 | Megan Davis Dailey | Behavioral Analyst | 36468 Emerald Coast Pkwy, Suite 2101, Destin, FL 32541-4799 | 2009-11-24 |
| 1679801393 | Kassi Joy Vanderploeg | Behavioral Analyst | 36468 Emerald Coast Pkwy, Suite 2101, Destin, FL 32541-4799 | 2009-11-19 |
| 1598909178 | Carolyn Davis | General Practice | 36468 Emerald Coast Pkwy, Suite 8102, Old South Centre, Destin, FL 32541-4799 | 2009-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578020574 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | Sec of Hwy 98 and Gulf Shore Drive, Destin, FL 32541 | 2019-02-26 |
| 1932640471 | Kathryn Clower | Chiropractor | 36474c Emerald Coast Pkwy Ste 3101, Destin, FL 32541 | 2017-03-16 |
| 1881133148 | Danielle Mckinney | Physical Therapist | 35008 Emerald Coast Pkwy Ste 400, Destin, FL 32541 | 2017-02-20 |
| 1417304643 | Coastal Pediatric Group | Pediatrics | 36468 Emerald Coast Pkwy Unit 2101, Destin, FL 32541 | 2016-05-17 |
| 1336563956 | Blu By The Sea,llc | Clinic/Center | 3399 Scenic Highway 98, Destin, FL 32541 | 2014-02-18 |
| 1740539535 | Courtney Breaux Mcgee | Physician Assistant | 155 Crystal Beach Drive #121, Destin, FL 32541 | 2012-09-07 |
| 1073861704 | Nathan Hall Dmd Pl | Dentist | 4484 Legendary Dr, Suite B, Destin, FL 32541 | 2012-08-28 |
| 1982991121 | Bayshore Retreat, LLC | Substance Abuse Rehabilitation Facility | 457 Cahoun Ave, Destin, FL 32541 | 2011-07-08 |
| 1457661605 | Destin Surgery Clinic, P.a. | Specialist | 415 Mountain Drive, Suite # 6, Destin, FL 32541 | 2010-10-20 |
| 1194032581 | Laura Mathisen | Behavioral Analyst | 3820 Misty Way, Destin, FL 32541 | 2010-09-07 |
| Find all providers in zip 32541 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053561126 | Erin M Hawkins | Counselor | 216 Diamond Cv, Destin, FL 32541-3669 | 2008-09-25 |
| 1215059563 | Michelle Ann Underwood | Counselor | 265 Mattie M Kelly Blvd, Destin, FL 32541-2876 | 2007-04-06 |
| 1710960273 | Randell Rudell Brooke | Counselor | 215 Mountain Dr, Suite 106, Destin, FL 32541-2346 | 2005-11-29 |
| 1972586444 | Michael Bradley Sturdivant | Counselor | 215 Mountain Dr, Emerald Coast Counseling Center #106, Destin, FL 32541-2346 | 2005-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588322 | Rebecca Ann Heald | Counselor | 2430 Duncan Dr, Niceville, FL 32578-2916 | 2020-11-02 |
| 1598366171 | Neurodiverse Ability Services LLC | Counselor | 608 Sw Marvin Burnett Rd, Lake City, FL 32025-4918 | 2020-11-02 |
| 1316547839 | Amber Kovach | Counselor | 8290 Matisse St, Champions Gate, FL 33896-8334 | 2020-10-26 |
| 1760081202 | Nih Holdings LLC | Counselor | 7711 N Military Trl Ste 1014, West Palm Beach, FL 33410-6506 | 2020-10-24 |
| 1346849072 | Blanca Rodriguez | Counselor | 1201 Lavender Jewel Ct, Plant City, FL 33563-2515 | 2020-10-23 |
| 1235738063 | Selena Giordano | Counselor | 1001 East Baker Street #100, Plant City, FL 33563 | 2020-10-22 |
| 1306444989 | Robert A Fahey | Counselor | 3927 Vine Tree Trl Apt A, Lake Worth, FL 33467-8540 | 2020-10-15 |
| 1952909178 | Elizabeth Leon | Counselor | 1067 Nw 119th St, North Miami, FL 33168-6240 | 2020-10-09 |
| 1518564301 | Lisa Chhabra | Counselor | 504 Pelican Ln N, Jupiter, FL 33458-8365 | 2020-10-05 |
| 1124635081 | Always Behavioral Counseling Services | Counselor | 5724 Byron Anthony Pl Apt 338, Sanford, FL 32771-8633 | 2020-09-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.